Monthly Archives: December 2018

Snow and Tell

To close out the year, I have (finally) added another photo gallery to ART@CHC, titled Shots at Large: Winter.  We get little enough snow here that, when it does fall, I am often inspired to go out shooting.  The current collection comprises the 12 most interesting shots from the past 20 years of my winter walkabouts.  More to the point, these are the few shots that I didn’t get bored with after hours of scanning, editing, etc.

I will be ringing in the new year with a new lightweight camera and lens (948 grams total) and a new desktop computer (it weighs a lot more).  My 2009 Windows 7 PC cannot run the 2019 version of Photoshop — and Windows 7 support will end in one year — so it was time to bite the bullet and get a new machine rather than upgrade the old one.  I am not looking forward to the task of migrating all my programs and files, a first-world problem by any definition.

As a lovely year-end parting gift to my faithful readers, here is a bonus shot that does not appear in my Winter gallery.  This is the road leading out of our neighborhood, one that demands low gear and a tight grip on the wheel on snowy days.  I hope that you and yours enjoy safe travels in the year ahead.

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Long Street in Asheville, North Carolina, is 0.2 miles (1000 feet) long.

Short Street in New Orleans, Louisiana, is 1.6 miles (8400 feet) long.

Straight Street in Forsyth, Georgia, heads northwest for 540 feet, then north for 360 feet, then northwest for 400 feet, then northeast for 700 feet, where it ends.

Ocean Side Drive in Florissant, Missouri, is 700 miles from the nearest (Atlantic) ocean.

La Paz Court in Salton City, California, is named for La Paz, Bolivia — highest capital city in the world — and lies 126 feet below sea level.

Hope Avenue in Pierce, Colorado is a thousand-foot unpaved dead-end.

Destiny Drive in Brunswick, Georgia, is a one-way street that circles around and ends up 150 steps from where it started.

• 1602 Happy Street and 1922 Moody Avenue in Mission, Texas, are next-door neighbors.

P Street in Fort Smith, Arkansas, is the site of the city wastewater treatment plant.

Trump Street is a narrow, crooked road in Daniels, West Virginia.  No, not that Daniels.

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The New Abnormal

Your ballroom days are over, baby
Night is drawing near
Shadows of the evening crawl across the years…

— from “Five to One” by Jim Morrison

A month ago today, I took my second ride in an ambulance.  No sirens, no racing through the streets.  In fact, it seemed like an incredibly slow ride.  The only thing that was racing was my heart, somewhere in the 130s as I recall.  Maybe higher.  I don’t remember a lot of details of the ride — I was trying my best to stay calm and trust that the EMTs were doing what they needed to do to stabilize me.  But I was scared as hell.

As it turns out, I have paroxysmal atrial fibrillation (AF).  Paroxysmal means that the AF spontaneously resolves on its own, as mine did during my hospital stay (with the help of some rate-control drugs).  But as I learned from my cardiologist, people rarely have just a single episode of AF.  As he put it, my next episode could be next week or next year, but he was all but certain that my AF will return.

Naturally, I have been doing a lot of reading about AF in the days since my scare.  One of the most informative articles I found was Diagnosis and Treatment of Atrial Fibrillation by Gutierrez and Blanchard in American Family Physician.  It spelled things out for me in extensive but readable detail.  The basic treatment strategy is this: (a) assume the patient will return to AF at some point; (b) but note that rhythm-control drugs have side-effects and have limited effectiveness; (c) therefore, prefer to use rate-control drugs to keep the heart from racing and injuring itself during future AF events; and (d) use anti-coagulants to keep clots from forming in the atrium (and going to the brain) if-and-when AF recurs.

I was already taking a beta-blocker, which is a blood-pressure and heart-rate control drug (the doctor tripled my dose).  But I am now also taking a so-called blood-thinner, which does not thin the blood per se but instead interferes with clotting.  I was sent home with a prescription for Xarelto (once a day) but have since switched to Eliquis (twice a day) since there is less side-effect bleeding with Eliquis.*  I read the research.

I am confident that my new cardiologist (not from our local hospital) now has me on the right course but he is still a bit mystified.  You see, AF is my second heart-related problem. It exists (paroxysmally, for now) alongside my left bundle-branch block (LBBB) which is a type of heart-muscle signal-conduction failure.  In essence, the left side of my heart does not get its own dedicated signal; instead, it has to “borrow” its signal from the right side.  My LBBB was discovered in the aftermath of my first ambulance ride, two decades ago — but who knows how long I had it before then.  What mystifies my new cardiologist is that I have been “walking around” with LBBB all these years and my heart is not in worse shape, to paraphrase his remarks during our visit.

It took me aback when he told me that — blood instantly rushed to the top of my head.  If I may explain:  After my LBBB diagnosis, it took me a good while to shake off the notion that I might suddenly drop dead.  I wandered through a two-year-long panic-infused funk.  So now, my cardiologist telling me not only that my AF will get worse but that my LBBB should have been worse was a one-two punch of cold sober.  It stirred up some of the old panic-funk, which I have been trying to keep at bay since the visit.

The cardiologist has ordered a cardiac MRI to help resolve the mystery.  I hope this will not deliver a third punch.  We will find out more in a few weeks.

Meanwhile, I mourn the loss of some familiar friends.  I can no longer take ibuprofen for headaches or sore muscles because of the bleeding risk.  I can no longer eat grapefruit or cranberries because they interfere with metabolism of the anti-coagulant.  I have had to virtually eliminate caffeine and alcohol, as both of these may trigger new episodes of AF.  Goodbye happy-hour martinis, hello carefully-measured splash of bitters to add flavor to some club soda.  That’s the way it is, as Walter Cronkite used to say.

• • • •

I did debate whether to write and post this.  In the end, I decided it had therapeutic value if nothing else.  I know many others have more painful stories to tell, and this one stands somewhere way back in the line.  I’m sure I will have a different perspective on all of this next week, next month and next year, but right now I’m just laying low, feeling an odd mix of carefulness, thankfulness and loss.

Thank you, Sue.  Bear with me.

___________

* Inexplicably, the hospital cardiologist sent me home with Xarelto, despite the fact that other doctors I saw in the hospital expressed their preference for Eliquis, as did my new cardiologist and my primary physician.  The hospital cardiologist apparently decided that my taking one pill a day (Xarelto), instead of two (Eliquis), was well worth the higher risk of internal bleeding.  Was I involved in the decision or informed of the risks before I was discharged?  Of course not.
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